Systematic review of evidence for the benefits of telemedicine

Alberta Heritage Foundation for Medical Research, Edmonton, Canada.
Journal of Telemedicine and Telecare (Impact Factor: 1.74). 02/2002; 8 Suppl 1(suppl 1):1-30. DOI: 10.1258/1357633021937604
Source: PubMed

ABSTRACT A systematic review of telemedicine assessments based on searches of electronic databases between 1966 and December 2000 identified 66 scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes, or results of economic assessment. Thirty-seven of the studies (56%) suggested that telemedicine had advantages over the alternative approach, 24 (36%) also drew attention to some negative aspects or were unclear whether telemedicine had advantages and five (8%) found that the alternative approach had advantages over telemedicine. The most convincing evidence on the efficacy and effectiveness of telemedicine was given by some of the studies on teleradiology (especially neurosurgical applications), telemental health, transmission of echocardiographic images, teledermatology, home telecare and on some medical consultations. However, even in these applications, most of the available literature referred only to pilot projects and to short-term outcomes. Few papers considered the long-term or routine use of telemedicine. For several applications, including teleradiology, savings and sometimes clinical benefit were obtained through avoidance of travel and associated delays. Studies of home care and monitoring applications showed convincing evidence of benefit, while those on teledermatology indicated that there were cost disadvantages to health-care providers, although not to patients. Forty-four of the studies (67%) appeared to have potential to influence future decisions on the telemedicine application under consideration. However, a number of these had methodological limitations. Although useful clinical and economic outcomes data have been obtained for some telemedicine applications, good-quality studies are still scarce and the generalizability of most assessment findings is rather limited.

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    • "During the past two decades, many broad reviews of telemedicine have been published, describing the state of knowledge and assessing – to some extent – the quality of the evidence at hand. Some reviews are wide ranging both in scope and geography [1], [2], some are broad in scope but restricted to some countries [3], some deal with specific perspectives of application (like diagnostic and management decisions) [4], [5], and rare ones look at costs [6]. Two recent systematic reviews added to the literature in this area: one assessed the effect of telemedicine on professional practice and on patient health care outcome [7] and the other was a systematic review of reviews about the effectiveness of telemedicine [8]. "
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    ABSTRACT: To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects.
    PLoS ONE 06/2014; 9(6):e98539. DOI:10.1371/journal.pone.0098539 · 3.23 Impact Factor
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    • "In the Design column, the level of scientific proof is indicated in parentheses [7]. performance of implantable Doppler would need to be assessed by exclusively comparing buried flaps). "
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    • "Systematic reviews have identified evidence for the advantages of telemedicine to society [48,15]. However there are still significant gaps in the evidence base between where telemedicine is used and where its use is supported by high-quality evidence [49]. "
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